Case Study: Systemic lupus Erythematosus (SLE) is an autoimmune disease in which the immune system attacks its own tissues, However, it appears most often in young women between the ages of 20 and 30. kidney involvement in SLE has been associated with higher mortality. A 19-year-old woman presented to the hospital with complaints of shortness of breath and lower and upper extremity severe edema over a past month. Additional complaints included alopecia and carpometacarpal joint pain. As for present illness, she had a first-time pregnancy but medical abortion was performed due to life treathening nephrotic syndrome a week ago when she was 5 months pregnant. On examination BP (160/90 mmHg) and anasarca. As for laboratory tests hemoglobin of 8.0 g/dL, serum creatinine 64.2umol/L(GFR-107ml/min/1.73m2) and urine protein 16 g/l/24h, dysmorphic RBC/++/, ANA IgG-2.0C.O/indext (0-1), anti-DsDNA 27u/mL(0-20), СЗ-20mg/dL(75-135), С4-4mg/dL(9-36mg/dL), IgG-374mg/dL(680-1145) respectively. Both kidney size enlarged 14.0x5.0 cm, respectively. Since we suspected SLE, decided to do a kidney biopsy to prove lupus nephritis. It revealed Lupus nephritis coexisted, class IV and V. In terms of Immunofluorescence, it revealed that IgG /++/, IgM /+/, IgA /+/ C1q /+/ C3/++/, C4 /+/. The patient was treated with MMFl 1000 mg (b.i.d), hydroxychloroquine 200 mg(b.i.d) combination with steroid as induction therapy and attained remission after 20 days of the treatment. When she discharge tests improved a lot (hemoglobin of 9.0 g/dL, Albumin 26.0g/L, and on urinalysis protein 2.0 g/l, dysmorphic RBC/+/). She lost 20 kg. It was first biopsy proven class IV and V lupus nephritis for us. Systemic lupus erythematosus should be considered in patients with nephrotic syndrome, especially child bearing age women and during early stage of pregnancy. We are willing to do more biopsy in order to clarify manifestation and feature of class IV and class V lupus nephritis in the future.